SECRETARY BLINKEN: Good morning, everyone. To my friend – longstanding friend – Nelson Cunningham, thank you for those wonderful words. But thank you even more for your leadership, for BCIU’s leadership. It is making a profound difference, and we are grateful for it. And to everyone here this morning, I see a remarkable community in this room. And “community” is the word, because so many people from so many different areas have come together in this fight, and it’s because of that, it’s because of that community – an enduring, powerful community – that so much extraordinary progress has been made.
Dee, thank you. Thank you for sharing your story. In and of itself, that takes remarkable courage. And in sharing it, you are inspiring so many other people. You are showing a way forward, and that’s going to make a difference in countless lives. It already has. That you’re here with us, and that you have a healthy baby daughter, that is – (applause). It tells us, it reminds us that an AIDS-free generation really is within our grasp, and how much that our world has to gain by actually achieving it. Your story is continuing; a new story is starting. It couldn’t be better than that.
Dr. Fauci, Dr. John – Mother Barbara. (Laughter.) It’s – we throw words around and we say it’s an honor to be with someone. It genuinely is an honor to be with the three of you. Those of us who are in government service in one way or another, we get to do a lot of things in our jobs. But to each in your own ways to have been the most extraordinary leaders in quite literally saving lives over so many years – I don’t think it gets any better than that. You have made, continue to make the most profound difference in the lives of so many people around the world. It is genuinely an honor to be with you today.
And let me just say one last thing. I think the first rule of politics is never follow Barbara Lee onto a podium. (Laughter.) But you have to do it sometimes.
So we are marking a celebration, but also a solemn occasion this World AIDS Day. We have – we’re celebrating a lot, but we have to start by acknowledging that 40 million lives were lost since the beginning of this epidemic in 1981. Those of you in this room who have been working on this for decades now – doctors, researchers, lawmakers, implementers of the President’s Emergency Plan For AIDS Relief – you’ve lost patients, you’ve lost colleagues, you’ve lost friends, you’ve lost loved ones. You know, you understand better than anyone, the human toll that lies behind the numbers that we talk about and throw around all the time.
The world was a different place before PEPFAR’s launch in 2003. At that time, a gap – a large gap – had emerged between wealthy and poor nations over access to antiretrovirals. In some parts of the world, when HIV-positive patients were first given their diagnosis, they were also told to prepare for the end. Coffinmakers, in many of these places, were making record profits.
When President George W. Bush launched PEPFAR, it changed the course of public health history – and, I would say, history in general. Much of the program’s success has been made possible by the leadership of, as I said, so many of you in this room, and of course many more outside it.
Dr. Fauci, as is well known, had already been working on HIV/AIDS for decades when, in the spring of 2002, President Bush asked him to travel to Africa to see if a program like PEPFAR could actually work on the ground.
It was on this trip that Dr. Fauci first met a CDC lab director in Côte d’Ivoire who happens to be with us today, Dr. Nkengasong, who helped show him that such a program was in fact feasible. So we are incredibly fortunate that Dr. John has continued his illustrious career in public health – including most recently as the first director of the Africa CDC. We’re luckier still that he is now leading PEPFAR’s future as our U.S. Global AIDS Coordinator. John, thank you. (Applause.)
So as history will record, on his return to Washington, Dr. Fauci presented his findings to President Bush, and he had in mind a strong program – $500 million.
At the end of the meeting, President Bush pulled Dr. Fauci aside and asked him to raise the program’s ambitions even higher and build what he called a game-changer for the developing world.
Months later, in the 2003 State of the Union Address, President Bush announced the United States Government would invest $15 billion in the global fight against HIV/AIDS over five years, noting – and I quote – that “seldom has history offered a greater opportunity to do so much for so many.”
Dr. Fauci, again, we – the world, the country knows you now so well for everything that you’ve done to lead us through this epidemic of COVID, but it’s so vital that people also know you for all that you’ve done for PEPFAR from its very outset, and for a lifetime of service that you’ve devoted to our country and to the world. Thank you. (Applause.)
Now, there’s another very important piece of history that needs to be recorded. You heard reference to it earlier. President Bush was able to launch such an ambitious program in no small part thanks to the tireless efforts of Congresswoman Lee and the Congressional Black Caucus. There is a letter sent to President Bush by the CBC in 2002 that should be in the Smithsonian, because that document was absolutely critical in focusing the president’s attention and urging him to take action. It called on the president to “launch a major new U.S. initiative to fight AIDS.” This leadership – that letter, Mother Barbara – that leadership was integral to PEPFAR’s start, as well as its subsequent congressional reauthorizations in 2008, in 2013, in 2018. And Barbara continues to be – and I use the word advisedly – one of the fiercest advocates to this day.
PEPFAR has benefitted from bipartisan support, as we’ve heard, across four presidencies, across ten Congresses. It’s resulted in an investment of more than $100 billion to the global HIV/AIDS response. This is the largest commitment by one country ever to address a single disease.
PEPFAR’s successes – bolstered through our multilateral contributions to the Global Fund – and the U.S. just hosted a very successful Seventh Replenishment of the fund in September – again, it’s easy to throw words around, but I think in this case they really apply – it’s been nothing short of extraordinary.
You’ve heard the numbers. More than 25 million lives saved; 70,000 community clinics, 3,000 laboratories built; 340,000 health care workers hired. Entire public health systems formed, with over a dozen countries which have either reached their HIV-treatment goals or managed control of the virus altogether.
And again, I just want to come back to what’s so important, I think, for – as a takeaway, and it really goes to what we heard from Dee. These numbers to so many of us are, yes, big numbers, but they’re abstractions. These are real lives. These are real stories, stories, again, that would have ended, but instead continued and started new stories – and not just stories, contributions – contributions to our world, contributions to our communities. That’s what this is all really fundamentally about. That’s what so powerful about it.
There’s something else that’s powerful, too. The systems put in place by PEPFAR have become an integral part of the health security architecture of countries around the world. They helped us to respond to emerging outbreaks like avian flu in 2009, Ebola in 2014. And the lessons that it’s taught public health experts, epidemiologists, community health workers, and others have played a central role in shaping our response to COVID-19 – from efforts to track the virus’s spread, to the quest to swiftly fund and manufacture safe, effective vaccines and treatments, to the logistics behind getting hundreds of millions of shots into arms. Now, we are continuing to build on PEPFAR’s many successes to create a stronger global health security architecture to prevent, to detect, to respond to future health emergencies. Doctor Fauci, you once said that PEPFAR “shows what the goodwill of a nation can do,” and you were right. PEPFAR also shows us what American diplomacy can do: bring together governments, bring together the public and private sectors, communities to tackle challenges that none of us can actually effectively deal with alone and that creates and has created a healthier, safer, and ultimately more secure world.
But here’s the truth: even as we celebrate the successes of PEPFAR, we cannot, we must not lose sight of the very serious work still required for us to end the global HIV health epidemic by 2030. Infection rates are again rising in many parts of the world. The UNAIDS report that was released just this week confirmed that persistent inequities continue to threaten progress for children, for young women and girls, and other at-risk populations such as the LGBTQI+ people, people who use drugs, and sex workers. Too many countries still have fragile and insufficiently resourced public health systems, which makes it difficult to offer services beyond HIV/AIDS treatments, and that undercuts our capacity to respond to emerging threats.
We now have a new Five-year PEPFAR Strategy; we launched it yesterday. And the primary purpose of that strategy is to fill those gaps. Among other efforts, PEPFAR will invest in targeted programming to reduce inequities among underserved populations like young women and girls. It will partner with more local organizations – faith-based, women, minority-led groups – which have trusted relationships with hard-to-reach communities. It will connect countries with development finance, commercial banks so that they can build their own regional manufacturing capabilities for antiretrovirals, for diagnostic tests, for personal protective gear, giving countries the capacity to meet their own challenges so that they’re not dependent on anyone else – and indeed not only the capacity to meet their own challenges, but to help others meet theirs. That is a powerful thing to do and vitally important.
In 2006 Ida Mukuka looked out at her two young daughters and wondered if she would be around to help them go to university. She’d recently been diagnosed as HIV positive in Zambia, treatments were still difficult to access – she wasn’t sure if she would survive until her daughters made it to school. Today, Ida is another one who is healthy. She has two daughters who are now young women, one on her way to grad school and the other a lawyer who is arguing cases before the high court of Zambia. And like the story you heard from Dee, like this story, like so many others, these are precisely the kind of achievements that PEPFAR has helped to make possible by furthering research on life-saving drugs, making those treatments available to individuals like Ida, like Dee, to people around the world.
Over the next five years, this latest PEPFAR strategy will keep making advancements like that possible so that millions more people can live healthy lives and live lives to their full potential. So it was important for me to come by today to see all of you, to be with all of you, to simply say this: thank you for such extraordinary work over so many years, but there’s work to do. The job is not finished; we’ve got to see it to the finish line. We’re determined to be your partners in doing that. Thank you very much. (Applause.)